一越来越多的证据表明用于治疗抑郁症和阿尔茨海默病的药物也可以帮助中风病人康复。
但从这些和其他恢复中风患者的药物研究中发现存在有比较矛盾的结果。任何一种治疗中风的药物在投入使用前都需要精心设计的大型实验为据，根据《Drugs and Aging》杂志的一项研究表明。
“这些药物尚未被明显证明有利于治疗中风。” Beristain博士说。
传统物理疗法已经是中风治疗方案的主流方法。但一半以上的中风幸存者会存有神经损伤。“这些康复措施的局限性引发了寻找提高神经复苏的其他方法。”Beristain和Golombievski说。
到目前为止，最有前景的药物治疗是抗抑郁药物，用以改善运动恢复，治疗阿尔茨海默病药物可提高失语症的康复(听、说、写的能力受损)。
约三分之一的中风患者有抑郁症，该病会限制病人康复的能力。越来越多的证据表明，被称为选择性5 -羟色胺再摄取抑制剂的抗抑郁药物，或者选择性血清素再吸收抑制剂(如百忧解、帕罗西汀和西普兰)，可提高神经复苏效果超过它们对情绪的影响。另一种类型的抗抑郁药，去甲肾上腺素再摄取抑制剂亦有效。
分析56种选择性血清素再吸收抑制剂药物的临床试验，发现该药物似乎可以改善依赖，残疾，卒中后神经功能缺损，焦虑和抑郁等症状。然而，这些研究结果应该谨慎对待，因为研究有不同的设计方案。几种另外的临床试验正在评估可提高中风恢复的抗抑郁药物的效果。
越来越多的证据表明，治疗阿尔茨海默症的药物被称为乙酰胆碱酯酶抑制剂(包括安理申，艾斯能和加兰他敏)可以改善中风患者的失语症。第二种类型的正在研究的老年痴呆症药物是美金刚胺(盐酸美金刚)。通过结合疗法， 与安慰剂相比，美金刚胺会对语言的恢复有好处，可持续至少一年。但临床证据表明美金刚胺对中风康复的治疗仍然有限。
But there are conflicting findings from studies of these and other drugs given to recovering stroke patients. Large, well-designed studies are needed before any drug can be recommended routinely for stroke recovery, according to a study in the journal Drugs and Aging by neurologists Xabier Beristain, MD, and Esteban Golombievski, MD, of Loyola University Medical Center and Loyola University Chicago Stritch School of Medicine.
"These medications have not yet been clearly proven to be of benefit to patients recovering from strokes," Dr. Beristain said.
Speech and physical therapies traditionally have been the mainstays of stroke rehabilitation programs. But more than half of stroke survivors are left with some neurological impairment. "The limitations of these rehabilitation efforts have sparked an interest in finding other ways to enhance neurological recovery," Drs. Beristain and Golombievski write.
So far, the most promising drug treatments are antidepressants to improve motor recovery and Alzheimer's disease drugs to boost recovery from aphasia (impaired ability to speak, write and understand verbal and written language).
about one in three stroke patients suffers depression, which can limit a patient's ability to participate in rehabilitation. There is mounting evidence that the class of antidepressants known as selective serotonin reuptake inhibitors, or SSRIs (such as Prozac, Paxil and Celexa), may enhance neurological recovery beyond their effect on mood. Another type of antidepressant, norepinephrine reuptake inhibitor (NRI) also has shown benefit.
An analysis of 56 clinical trials of SSRIs found the drugs appeared to improve dependence, disability, neurological impairment, anxiety and depression after stroke. However, these findings should be taken with caution because the studies have different designs. Several additional clinical trials now underway are evaluating the use of antidepressants to enhance stroke recovery.
There is growing evidence that Alzheimer's disease drugs called acetylcholinesterase inhibitors (including Aricept, Exelon and Razadyne) can improve aphasia in stroke patients. A second type of Alzheimer's medication under study is memantine (Namenda). When used in combination with therapy, memantine has shown language benefits lasting at least one year when compared with a placebo. But clinical evidence of memantine for stroke recovery remains limited.
So far, most studies of these and other drugs used for stroke recovery have been small, employing different methodologies and time windows between the stroke and the clinical intervention.
"We need well-designed, large clinical trials with enough power to establish the usefulness of medications as adjuvants to rehabilitation before we can routinely recommend the use of these agents to enhance neurological recovery after stroke," Drs. Beristain and Golombievski write.